Contemporary Nursing Issues Trends And Management 4th Edition By Jacob -Test Bank

Cherry: Contemporary Nursing, 4th Edition Test Bank Chapter 12: Workforce Advocacy and the Nursing Shortage MULTIPLE CHOICE 1. When a registered nurse (RN) is asked to accept an assignment that he or she may not be qualified to perform, the nurse should A. believe the assignment was right if assigned by a legitimate power. B. be primarily concerned with the number of patients being assigned. C. ask how other nurses have handled the assignment in the past. D. determine whether he or she is familiar with the types of patients being assigned. ANS: D (D) is correct because nurses should always think critically about assignments so they can communicate what makes them uncomfortable about a particular assignment. If nurses do not have the knowledge or experience required for particular patient assignments, then modification of the assignments is in order to ensure patient safety. (A) is incorrect because even if the person who makes the assignment has legitimate power, he or she may not be aware of the nurse’s work experiences and training. (B) is incorrect because the nurse should not respond on the basis of the actual number of patients assigned but should consider the needs of each patient, his or her age and condition, other factors that contribute to special needs, and the resources available to meet those needs. (C) is incorrect because each nurse possesses individual expertise. Basing decisions on the actions and capabilities of others is incorrect and is potentially unsafe for the patient. DIF: Application REF: Page 268, Box 12-8 page 270 2. One workplace issue—the nursing shortage—is caused by several complex issues, including A. movement of nurses into acute care settings. B. the use of unlicensed assistive personnel to replace RNs. C. a mass of “baby boomers” who have chosen nursing as a career. D. an aging nursing workforce. ANS: D (D) is correct because recent research validates that an aging population and an aging nursing workforce are both significant contributors to the nursing shortage issue. (A) is incorrect because movement of nurses into acute care settings would actually be beneficial in terms of the nursing shortage. As patient care technology increases, the number of nurses needed in acute care settings is increasing. (B) is incorrect because unlicensed assistive personnel cannot be used to replace RNs, although they can be placed in positions that allow them to assist RNs in providing patient care. (C) is incorrect because there has not been a mass of “baby boomers” who have chosen nursing as a career. DIF: Comprehension REF: Page 262 3. Studies conducted to determine why enrollment in nursing schools has declined found A. that a greater number of individuals chose nursing as a career but could not meet entrance requirements. B. fewer young individuals are available to enter the workforce. C. fewer career opportunities exist for women outside of nursing. D. men have dominated the profession, and women feel that they have experienced discrimination. ANS: B (B) is correct because younger birth cohorts (those born after 1955) are smaller in population size resulting in fewer potential nursing profession candidates. (A) is incorrect because many qualified nursing candidates are turned away because of limited enrollment in nursing schools. The shortage of nursing school faculty limits the number of applicants that can be accepted for admission. (C) is incorrect because actually, job opportunities are more numerous than ever for women. (D) is incorrect because men remain a minority in the nursing profession. DIF: Analysis REF: Pages 258-259 4. Along with the shortage of enrollment reported in nursing schools is a shortage of faculty, which is attributed to several factors, including A. substantial salaries, but the burden of research that leads to burnout. B. that faculty choose employment where work hours are more flexible. C. increased enrollment in doctoral programs but only in the areas of research and clinical practice, not in the specialty of education. D. increasing job competition from higher paying clinical sites. ANS: D (D) is correct because according to Yordy (2006), academic institutions, especially those faced with budget cuts, generally cannot compete with nonacademic employers. Faculty salaries continue to be a major contributor to the nursing shortage. (A) is incorrect because faculty salaries are not substantial, and research is not a job requirement in many nursing faculty positions. (B) is incorrect because the educational setting is so desperate for nursing faculty that scheduling flexibility usually is not an issue. Most nursing faculty members actually have greater flexibility with regard to weekend and holiday scheduling than do clinical nurses. (C) is incorrect because enrollment in doctoral programs has not increased in any specialty area because of the faculty shortage. DIF: Comprehension REF: Page 260 5. The key to organizational success for health care facilities is A. hiring younger, more energetic nurses. B. offering incentives such as sign-on bonuses. C. hiring highly qualified advanced practice nurses. D. retaining professional nurses. ANS: D (D) is correct because past nursing shortages have proved that retention of professional nurses is the key to any organization’s success. Nurses want to work in an environment that supports decision making and effective nurse-physician relationships. The ability of an organization to retain nurses primarily depends on the creation of an environment that is conducive to professional autonomy. (A) is incorrect because younger nurses want flexible hours and considerable autonomy in the work environment. These options are limited in the current health care environment, where round-the-clock patient care, including on weekends and holidays, is mandatory. (B) is incorrect because offering sign-on bonuses actually results in considerable expenditure by the health care organization. Many believe that these recruitment-related costs could be better spent by increasing basic compensation levels of professional nurses. (C) is incorrect because hiring highly qualified advanced practice nurses does help to improve patient outcomes but does not provide the staffing needed for direct patient care. DIF: Application REF: Page 260 6. Magnet hospitals are those work environments that A. attract physicians but repel nurses. B. lack appreciation for nursing certification. C. not only attract but also retain professional nurses. D. discourage nurses from advancing their current level of education. ANS: C (C) is correct because Magnet hospitals are those that have been identified as both attracting and retaining professional nurses. A study conducted in 1983 identified workplace factors such as management style, nursing autonomy, quality of leadership, organizational structure, professional practice, career development, and quality of patient care as influencing nurse job satisfaction and turnover rates (i.e., higher retention). (A) is incorrect because Magnet hospital nurses have higher levels of autonomy, greater control over the practice setting, and better relationships with physicians. Magnet hospitals actually attract both physicians and nurses. (B) is incorrect because Magnet hospitals actually recruit and reward professional nurses with specialty certification. (D) is incorrect because Magnet hospitals have programs that support nurses in advancing their education. DIF: Comprehension REF: Pages 260-261 7. Which of the following situations would be considered a workplace advocacy issue that is reportable to the state nurses association or the Center for American Nurses if it is not resolved at the local level? A. Nurses prefer to wear navy blue scrubs but the institution requires burgundy scrubs, which interferes with autonomy. B. The cafeteria often serves fried vegetables rather than healthier baked vegetables, causing the potential for hyperlipidemia. C. The hospital pharmacy does not fill employee prescriptions upon receiving them; instead, they fill employee prescriptions after all inpatient prescriptions have been filled. D. The key needed to change the sharps container is locked in the supervisor’s office after 3 PM on weekdays and all day on weekends, which prevents changing of the container when needed and places nurses at risk for needlesticks. ANS: D (D) is correct because a safe work environment is imperative for the safety of both nurses and patients. Correcting this work environment issue promotes job satisfaction and patient outcomes. (A), (B), and (C) are incorrect because these issues do not affect nurse safety or patient outcomes; therefore advocacy intervention is not appropriate. DIF: Analysis REF: Pages 254-257, 276 8. A newly hired nurse is asked to serve on a committee formed to recruit and retain nurses. At the committee meeting, the nurse learns that A. older nurses are being encouraged to retire, so that younger, more efficient nurses can practice. B. Magnet hospitals are able to attract nurses with sign-on bonuses and flexible work hours but fail to retain nurses because insufficient autonomy over professional practice is provided. C. multitasking is seldom desired by the younger generation of nurses. D. many younger workers are less concerned with longevity and are willing to change institutions to achieve professional advancement and flexible work hours. ANS: D (D) is correct because the emerging workforce, aged 18 to 35 years, has compensation expectations that differ from those of previous generations. This younger generation prefers to work in an outcomes-based environment, where pay is based on achievement or merit, not on longevity. (A) is incorrect because older nurses are actually being recruited to stay in the employment arena to improve patient outcomes. Research advancements in ergonomics and workload have made early retirement less appealing. (B) is incorrect because Magnet hospitals definitely retain nurses by offering professional practice autonomy. (C) is incorrect because the younger generation is very adept at multitasking and at using technology. DIF: Application REF: Page 263 9. Hospitals surveyed nurses who had terminated their employment to determine why they had chosen to leave. One of the most common reasons for leaving was A. decreased pay for alternative shifts. B. that the nurse/patient ratio prevents safe care. C. that most facilities are choosing an all-RN staff, which decreases opportunities for advancement. D. that agency and foreign nurses are favored by administration over full-time nursing staff. ANS: B (B) is correct because a number of studies in the late 1990s focused on the work environment as a significant contributor to the difficulties involved in recruiting and retaining RNs. One of the primary factors for the increasing nurse turnover rate was identified as workload and staffing patterns. A more recent study by Aiken (2002) reported higher rates of patient complications and increased death rates when fewer nurses are assigned per patient. (A) is incorrect because substantial monetary compensation is provided for alternative shifts. (C) is incorrect because an all-RN staff would not limit advancement opportunities. (D) is incorrect because use of agency and foreign nurses results in considerable expenditures by health care organizations. Many believe that these recruitment-related costs would be better spent by increasing the basic compensation levels of professional nurses. DIF: Comprehension REF: Pages 265-266 10. A staff nurse serves on a shared governance council that has been given the authority to decide issues related to “self-scheduling” and “use of unlicensed assistive personnel.” Council chairs make all final decisions regarding nurse/patient ratios and use of agency nurses. This phase of shared governance is phase A. 1. B. 2. C. 3. D. 4. ANS: C (C) is correct because in the third developmental phase of shared governance, staff nurse representatives serve on councils that are assigned authority to handle specific functions. At this level, council chairs make up the management committee that is charged with making all final operational decisions. (A) is incorrect because phase 1 includes staff nurse representatives who have the authority to address designated practice issues and some authority to determine roles, functions, and processes. Managers are responsible for facilitating practice through resource management and allocation. The executive committee accepts recommendations from staff nurses and managers. The chief nurse executive retains final decision-making authority. (B) is incorrect because in phase 2, staff nurse representatives serve on committees that are designated for specific management and/or clinical functions. Managers serve on the same committees with staff nurses. Committee chairs are appointed by the chief nurse executive, and the nursing cabinet makes final decisions on the basis of recommendations received from the committees. (D) is incorrect because shared governance has passed through only three developmental phases. DIF: Application REF: Page 272, Box 12-9 11. A nurse is concerned about safe staffing levels at her facility and observes that several units have no RN coverage but instead have RNs who float among several units. In determining whether this staffing concern should be reported to an outside agency, which of the following is appropriate to consider regarding whistle blowing? A. Reporting unsafe staffing levels to The Joint Commission provides protection from the employer. B. Keeping copies of inappropriate staffing patterns in the nurse’s personal file is illegal. C. When observing inappropriate staffing, the nurse should record her personal thoughts concerning the outcomes. D. One should seek guidance from a trusted individual who can provide an objective point of view. ANS: D (D) is correct because one of the many guidelines of whistle blowing specifies that one should seek counsel from a trusted individual outside of the situation to gain an objective perspective. (A) is incorrect because private groups such as The Joint Commission do not confer protection in whistle-blowing situations; a nurse must report to a state or national regulator. (B) is incorrect because this action is not illegal. (C) is incorrect because the nurse should record objective information, not personal thoughts or interpretations. DIF: Analysis REF: Page 275, Box 12-11 12. The occupational health and safety nurse would like to develop programs designed to decrease mortality and morbidity among the workforce. When considering factors related to mortality among female workers, the nurse should focus her efforts on prevention of A. suicide. B. homicide. C. blood-borne disease. D. ergonomic hazards. ANS: B (B) is correct because workplace violence has become a major societal issue. Its most extreme form, homicide, is the fourth leading cause of fatal occupational injury in the United States, with 551 workplace homicides reported in 2004 out of a total of 5703 fatal work injuries (OSHA, 2006b). (A) is incorrect because suicide is not a strong mortality issue in the workforce. (C) is incorrect because mortality due to blood-borne pathogen exposure has decreased since the Needlestick Safety and Prevention Act was implemented. (D) is incorrect because ergonomic hazards have decreased since safe patient handling educational programs were implemented. DIF: Application REF: Page 278 13. According to the Needlestick Safety and Prevention Act (1991), A. employers must mandate policies for nonmanagerial employees to prevent patients from being exposed to used needles. B. employers are not responsible when employees fail to follow universal precautions, resulting in a needlestick. C. each state must determine the degree of input sought from employees to determine safe workplace policies involving protection from sharps injuries. D. employers are required to document how and where a sharps injury occurred, including the brand of device that was involved. ANS: D (D) is correct because this act, passed at the federal level, requires the use of safer needle devices to protect from sharps injuries; the law requires employers to maintain a sharps injury log that contains, at a minimum, the brand of device involved in the incident, the department or work area where the exposure incident occurred, and an explanation of how the incident occurred. (A) is incorrect because the law requires employers to solicit the input of nonmanagerial employees responsible for direct patient care who are potentially exposed to sharps injuries in the identification, evaluation, and selection of effective engineering and work practice controls. (B) is incorrect because employers are responsible for the identification, evaluation, and selection of effective engineering and work practice controls to prevent needlesticks. (C) is incorrect because the Needlestick Safety and Prevention Act is a federal law, and all states are held to this statute. DIF: Comprehension REF: Page 276 MULTIPLE RESPONSE 1. Hospital quality improvement committee members, who were researching interventions designed to enhance patient safety and reduce the occurrence of preventable deaths, decided to base their interventions on the recommendations of the Institute for Healthcare Improvement’s (IHI) 100,000 Lives Campaign , which included the following: (Select all that apply.) A. Implement best practices to reduce death related to heart failure caused by cardiomyopathy. B. Compile the most accurate list of all medications a patient is taking and compare with the physician’s admission, transfer, and/or discharge orders. C. Employ a team of specially trained interdisciplinary providers who can recognize and respond to worsening patient conditions. D. Decrease nosocomial infections by implementing procedures for central line care based on scientific findings. E. Reduce the number of nonlicensed personnel who provide direct patient care. ANS: B, C, D (B), (C), and (D) are correct because these are three of the six areas identified by the IHI in 2006 that would improve patient safety and thereby decrease medical errors leading to patient deaths. (A) is incorrect because this is an implementation that specifically relates to the nonpreventable medical diagnosis of heart failure due to cardiomyopathy; it was not a component of the IHI 100,000 Lives Campaign. (E) is incorrect because reducing the number of nonlicensed personnel who provide direct patient care was not a component of the IHI 100,000 Lives Campaign. DIF: Analysis REF: Page 274 COMPLETION 1. Nurses who are expected to work overtime as dictated by their employer are being subjected to a ____________________ hazard in the workplace. ANS: psychologic Hazards in the workplace are categorized as follows: biologic, ergonomic, chemical, physical, and psychologic. Included in psychologic hazards are issues such as stress, shift work, mandatory overtime, and verbal abuse by patients and other health care providers. DIF: Application REF: Page 276, Box 12-12 Cherry: Contemporary Nursing, 4th Edition Test Bank Chapter 15: Nursing Leadership and Management MULTIPLE CHOICE 1. In an attempt to persuade employees to bargain for another type of health insurance, a handout is circulated that describes the present employees’ health care insurance as being insensitive, limiting choices of care providers, and providing inferior care. This reflects which aspect of planned change? A. Unfreeze B. Move C. Refreeze D. Acceptance ANS: A In alignment with Lewin’s stages of change (unfreezing, moving, and refreezing), education and involvement are keys to successful change. (A) is correct because the change agent promotes problem identification and encourages awareness of the need for change. People must believe that improvement is possible before they will be willing to consider change. (B) is incorrect because at this stage, the change agent clarifies the need to change, explores alternatives, defines goals and objectives, plans the change, and implements the change plan. (C) is incorrect because at this stage, the change is being integrated into the organization so that it becomes recognized as the status quo. The change agent must facilitate change by monitoring adherence to the new requirements. (D) is incorrect because acceptance and integration represent the final aspect of any change. DIF: Application REF: Pages 352-354 2. In differentiating between a leader and a manager, it can be seen that A. a leader has legitimate authority. B. a manager motivates and inspires others. C. a manager focuses on coordinating resources. D. a leader focuses on accomplishing goals of the organization. ANS: C The terms leadership and management are used interchangeably, and it is difficult to discuss one without discussing the other. However, these roles have specific traits unique to themselves. (C) is correct because the manager is the coordinator of resources (time, people, and supplies) needed to achieve outcomes. (A) is incorrect because authority is the legitimate right to direct others that is given to a person by the organization through assignment to an authorized position such as a nurse manager. (B) is incorrect because it is the nurse leader who has the ability to guide or influence, as well as to motivate and inspire, others on the team. (D) is incorrect because managers are assigned responsibility for accomplishing the goals of an organization. DIF: Comprehension REF: Page 331 3. The first step in the nursing process and in the problem-solving process is to A. identify the problem. B. gather information. C. consider the consequences. D. implement interventions. ANS: B The nursing process, which is familiar to nurses who address patient care needs, can be applied to all management activities that require decision making and problem solving. (B) is the correct answer because as in the nursing process and the problem-solving process, one must first gather information about the problem or situation. (A), (C), and (D) are the steps that follow in the nursing and problem-solving processes. DIF: Comprehension REF: Page 350, Table-15-1 page 351 4. An explosion just occurred at the local factory, and hundreds of employees have sustained varying degrees of injury. Which type of nursing leadership is most effective in this situation? A. Autocratic B. Democratic C. Laissez-faire D. Situational ANS: D (D) is correct because of the dynamics of the situation that the leader has to work within. Interaction between the leader, the worker, and the elements of the leadership situation involves several variables: organizational culture, values of the leader and values of the followers, influence of the leader/manager, complexities of the situation, work to be accomplished, and the environment. (A), (B), and (C) are incorrect because these are general leadership styles that are not related to specific situations. DIF: Application REF: Page 333 5. A registered nurse (RN) with excellent assessment and psychomotor skills would derive power on the basis of which source? A. Rewards B. Coercion C. Expert D. Legitimate ANS: C Seven (7) primary sources of power are known. For this question, response (C) is correct because Expert power is based on knowledge, skills, and information. (A) is incorrect because Rewards power comes from the ability to reward others for complying; it may include such rewards as money, desired assignments or recognition. (B) is incorrect because Coercive power is based on fear of punishment or failure to comply. (D) is incorrect because Legitimate power is based on holding an official position within the organization. DIF: Application REF: Pages 331-332 6. Managers who exhibit the authoritative behavioral style are most likely to use which source of power? A. Informal B. Expert C. Coercive D. Reward ANS: C Seven (7) primary sources of power are known. For this question, response (C) is correct because Coercive power is based on fear of punishment or failure to comply. Coercive power fits well into the authoritative behavioral style because authoritative managers dictate the work with much control, usually ignore the ideas or suggestions of subordinates, and provide little feedback or recognition for work accomplished. (A) is incorrect because Informal power is not one of the seven primary sources of power; however, informal leaders may distribute a considerable amount of power among the workers, can influence the attitude of the group, and significantly affects the efficiency and effectiveness associated with work flow, goal setting, and problem solving. (B) is incorrect because Expert power is based on knowledge, skills, and information. (D) is incorrect because Rewards power results from the ability to reward others for complying and may include such rewards as money, desired assignments or recognition. DIF: Application REF: Pages 331-332, Box 15-3 page 336 7. The illustration below identifies which type of chart? A. Productivity B. Organizational C. Resource D. Staffing ANS: B (B) is correct because an organizational chart is a visual picture of an organization that identifies lines of communication and authority. (A) is incorrect because productivity is the amount of output or work that is produced with a specific quantity of input or resources. (C) is incorrect because resources include personnel, time, and supplies needed to accomplish the goals of an organization. (D) is incorrect because staffing is the manpower needed to complete the work. DIF: Comprehension REF: Page 341 8. Florence Nightingale is attributed with being intelligent (she developed statistical methods to evaluate health care), dependable (she often worked long hours to care for the injured), and ambitious (she fought against society’s perception of nursing). Those who depict her as a leader on the basis of these qualities are practicing which leadership theory? A. Trait B. Chaos C. Bureaucracy D. Organizational ANS: A (A) is correct because leadership trait theory describes intrinsic traits of leaders and is based on the assumption that leaders were born with particular leadership characteristics. Other traits found to be associated with this leadership theory include intelligence, alertness, dependability, energy, drive, enthusiasm, ambition, decisiveness, self-confidence, cooperativeness, and technical mastery. (B) is incorrect because chaos is an organizational theory that attempts to account for complexity and randomness in organizations. (C) is incorrect because bureaucracy is part of the organizational theory that provides an understanding of authority within organizations. (D) is incorrect because organizational theory provides the framework for an understanding of leadership and management, and for an understanding of complex organizations. DIF: Application REF: Pages 332-333 9. A nurse manager is concerned with restocking the emergency cart, creating the staff schedule, requesting floor stock from pharmacy, and checking the orders on patient charts. Which type of leader accurately describes this nurse? A. Transactional B. Situational C. Transformational D. Contemporary ANS: A (A) is correct because the transactional leader is concerned with the day-to-day operations of the facility. (C) is incorrect because the transformational leader is committed to organizational goals, has a vision, and is able to empower others with that vision. (B) and (D) are incorrect because situational and behavioral theories have attempted to integrate the dynamics of the interaction between the leader, the worker, and elements of the leadership situation, arguing that effective leadership depends on several variables. Theses two theories are subsumed under the theory of contemporary theories of leadership. DIF: Application REF: Page 333, Box 15-1 10. According to the unit’s policy for call-ins, a nurse is suspended for 3 days because of excessive call-ins that occur within 15 minutes of shift change. The nurse states, “You are unfair to me.” Which theory would disprove the nurse’s statement? A. Bureaucracy B. Closed systems C. Open systems D. Trait ANS: A (A) is correct because Weber’s concept of bureaucracy revolves around the assumption that authority confers the right to issue commands within an organization on the basis of impersonal rules and rights, by virtue of the management position rather than any trait ascribed to the person who occupies that position. Other characteristics include the following: Impersonal rules govern the actions of superiors over subordinates, all personnel are chosen for their competence and are subject to strict rules that are applied impersonally and uniformly, and a system of procedures for dealing with work situations is in place. (B) and (C) are incorrect because they represent the systems theory of the organization. There are two views: open and closed. Closed systems theory views the system as being totally independent of outside influence, whereas open systems theory suggests that the organization is affected not only by internal change but also by external environmental changes that can have a direct or an indirect influence on the organization. (D) is incorrect because trait theory, which describes intrinsic traits of leaders, is based on the assumption that leaders were born with particular leadership characteristics. Other traits found to be associated with this leadership theory include intelligence, alertness, dependability, energy, drive, enthusiasm, ambition, decisiveness, self-confidence, cooperativeness, and technical mastery. DIF: Analysis REF: Pages 335-336 11. A nurse is reading about positive reinforcement with the goal of increasing staff motivation. Which of the following actions would demonstrate positive reinforcement? A. Every morning at shift change, thank each employee for an excellent job. B. Rotate a monthly “employee recognition award” among all employees on the unit. C. Wait until the annual performance review to recognize accomplishments. D. Give spur-of-the-moment recognition to an employee who has accomplished a goal. ANS: D (D) is correct because to be effective, positive reinforcement should (1) be specific, with praise given for a particular task done well or a goal accomplished; (2) occur as close as possible to the time of the achievement; (3) be spontaneous and unpredictable (praise given routinely tends to lose value); and (4) be given for a genuine accomplishment. (A), (B), and (C) are incorrect because they lack spur-of-the moment, spontaneous recognition for a genuine accomplishment. DIF: Application REF: Page 344 12. A key management function is strategic planning. Which of the following represents this function? A. Determining that all nurses on the unit understand the current organizational philosophy B. Evaluating the communication process between the pharmacy and the nursing departments C. Monitoring data from the quality management initiative related to the last three orientation programs D. Developing a 5-year plan that will incorporate the clinical nurse leader as a part of all nursing units ANS: D (D) is correct because a strategic plan is a written document that details organizational goals, allocates resources, assigns responsibilities, and determines time frames. The strategic plan generally looks 3 to 5 years into the future. (A), (B), and (C) are incorrect because they are all forms of current evaluation and analysis, and they do not look toward the future. DIF: Comprehension REF: Pages 339-340 13. A hospital’s policy requires that all nurse managers must have a minimum of a bachelor’s degree in nursing. A BSN nurse new to the hospital has recently been hired as nurse manager for the oncology unit. A registered nurse who has worked on this unit for many years is unable to be promoted to a nurse manager position because of his educational status and has been commenting to both physicians and staff that, “The new nurse manager has book sense but no leadership abilities.” What is the best approach that can be used by the new nurse manager who is attempting to gain the trust and respect of the nursing staff on the unit? A. Send memos to all staff except the upset nurse to invite them to a luncheon. B. Ask management to transfer the upset nurse to another unit. C. Assign the upset nurse to committees that do not directly affect that nursing unit. D. Acknowledge the clinical expertise of the upset nurse and clearly explain the expectations for teamwork and open, honest communication. ANS: D (D) is correct because the best way for the new nurse manager to communicate with this employee, who may be an informal leader, is to show respect for the individual’s clinical expertise and experience through clear and direct communication. The new nurse manager should attempt to identify the staff nurse’s power as an informal leader, should involve him and other staff members in decision making and change implementation processes, and should clearly communicate goals and work expectations to all staff members. (A) is not correct because the nurse manager would not gain the respect or trust of other nurses on the unit by excluding one of their peers from an activity. (B) is not correct because the nurse manager must make a sincere attempt to work with the nurse, whose clinical experience is valuable to the unit. A transfer request would be the last option after all other efforts to develop a working relationship with the staff nurse have been exhausted. (C) is not correct because the best way to work with this employee and gain the respect of other nurses on the unit is through open and direct communication. DIF: Analysis REF: Page 332 MULTIPLE RESPONSE 1. Registered nurses who are entering the workforce will have expanded leadership responsibilities that include (Select all that apply.) A. serving on interdisciplinary care teams. B. being competent to work in several areas independently when dictated by patient census. C. attending a meeting to plan advanced training for unlicensed assistive personnel. D. evaluating outcomes of care that are reported to a standing committee. ANS: A, C, D (A), (C), and (D) are correct because the new nurses will be placed in many situations that require leadership and management skills, for example, managing a group of assigned patients, serving on a task force or committee, acting as team leaders or charge nurses, and supervising unlicensed assistive personnel and licensed vocational/practical nurses. (B) is incorrect because for RNs who are entering the workforce, being competent to work in several areas independently is not a realistic expectation. DIF: Application REF: Page 330 OTHER 1. Place the following five major management functions into correct sequential order. A. Staffing B. Directing C. Planning D. Controlling E. Organizing ANS: C, E, A, B, D Each of the management activities of planning, organizing, staffing, directing, and controlling come into play in the role of resource manager. The nurse must develop skills in the following ordered areas: C. Planning for the necessary resources (primarily staff and supplies) to manage the unit; planning serves as the basis for all other management functions; thus, it comes first in sequential order. E. Organizing resources to meet identified goals; organizing identifies the numbers and types of staff needed to meet goals, thus must occur prior to staffing. A. Staffing appropriately as determined by patient needs and the budget plan; staff must be hired and in place prior to directing. B. Directing. After managers have planned what to do, organized how to do it, and staffed positions to do the work; they must direct personnel and activities to accomplish goals. D. Controlling is the final management function by which managers, through staffing and directing, ensure that employees accomplish planned goals within the established organizational structure. DIF: Analyzing REF: Page 338